HomeMy WebLinkAbout2006-P10482 - sewer connect PERMIT !
CITY OF 4RON0 �
2750�t;elley Parkway- PO Box 66 Permit Number: p1o482 '
Crystal Bay, Minnesota 55323 Permit Type:
Sewer a d Water Permit
(952) 249-4600 Date Issued: l0/23/2 6
SITE ADDRESS: I 3085 7amestown Rd Unit#
Long Lake,MN 55356 I�
PID: 2g_118-23-33-0010
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: Sewer and Water Pernut Permit Sub-type(s): Sewer Coru}ecrion
DETAILS: '
Approved per resolution#: I
Separate permits required:
NOTICES/REMARKS:
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FEE SUMMARY: Permit Fee: $ 35.00 valuation: $ 0.00 !
State Surcharge Fee: $ 0.50 I
TOTAL FEE: $ 35.50 j
APPLICANT: Ritter Excavating OWNER: Mr.&Mrs.Gary Larson I
7120 Vernon Street 3085 Jamestown Rd
Rockford,MN 55373 Long Lake MN 55356 I'
THE UNDERSIGNED HEREBY RE UE T P I
Q S S ERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED I
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES ANDISTATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
1
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APPLICANT PFJRMITEE SIGNATURE IS D BY SIGNATCJRE
Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septiq 1-Septic) Page 1
+ i
• EOR CITY,USE ONLY �
��� Clty Of Ol'ono Date Recerved.,! Permit# �_ .;
O� Q P.O.Box 66 - �
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� ❑In-House SAC Determmation Form Cum leted .
2750 Kelley Parkway p
� ���'���'�. � Crystal Bay,MN 55323 ApproVed By(If Required)
���`���'i�,�o (952)249-4G00 I
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CITY OF ORONO-SEWER&WATER/GENERAL PERMIT � 5`���
(*Note:Some permits may require approval by the Building Official and/or Public Works Department*) I
(A�.L PERMITS- NI�v be subiect to Curther review and mav not be issued when thc annlication is receivec�) ��
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GENERAL INFORIVIATION '
1. You may apply for utility pennits by mail or in person at the City offices. '!
2. 1�blailed in applications are subject to the postage and handling fee shown below. Pernut cards will
be sent by reriu7l mail within 2 business days. i
3. Permits are not valid until you receive a permit card.
4. Work must not begin unless the pernut card is available on the job site.
5. Urility connection pernuts may be issued to licensed contractors only. 'i
6. Contact the Public Works Department(952-249-4600)for utility stub as-built locations.
DO NOT EXCAVATE IN ANY STREET AND DO NOT TAP ANY MAIN without�xpress
approval of the Public Works Department. Issuance of a pemut does not grant this ap�roval.
7. All work must be done in accordance with State Code requirements.
8. All work�nust be inspected before it is covered. Call(952)249-4600,24+hour notice required.
- : TYPE OF`PERIVIIT
� (Check All That Ap ly) `.. t
❑ Residential(May Require Approval) ❑Comnlercial(Approval Requued) !
�New Connection ❑Additional Connection ❑Re-Connection ❑Repairs ❑Discqnnect
Job Site/ Owrier Information: '
'te Ad ress:
O �'✓� _ J'�
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Owner� G��r- Mailing Address: � �✓�' I - ��
City: �- Zip: �����.le
Home Phone: ��� �f 73 4'��/� Alternate Phone: I
Contractor Information:
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Contractor:,(/�� f,��-����--�'L�Contact Person: �--
Address: �/ 2 U ���ax � State License#: ( �� l I
City: /��� Zip:�7�Expiration Date: �� '_��� �'�
Phone: ��� � 7� �� `f`� Alternate Phone: �f Z '�l � '�Gf � �
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i 1 � �� DETERIYII.�FINC� � - � '� ti . -�Frr &�' �-
� ��� �� �:�� P.ERMIT FBES; }� ,._: � M;
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❑ SAC Charge(2005 Rate=$1,550.00) $
(SAC Charge must accompany all sewer pernut applications unless prepaid)
(Orono City Staff can deternune if applicable)
(If not prepaid,a sewer connection permit will not be issued)
❑ Sewer Connection/Disconnect/Repair($35.00/Per Stub) $
Pipe size inclies;material Schd 40 air tested; cast iron
❑Water Connection/Disconnect/Repair($35.Q0/Per Stub) $
Pipe size uiches;material Schd 40 air tested; copper
1. SUBTOTAL of Pennit Requested: $
2. STATE SURCHARGE $ .50
3. POSTAGE&HANDLING(Only on Mail-In A�plicadons) $ 1.50
4. TOTAL PERMIT FEE(Add L'uies 1-3 Above) $
: , , .
ADDITIONAL Il�'FqRMATION—WATER METERS
■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a seuarate pernut.
■ WATER METERS must be set and sealed by Orono Water Department (952) 249-4600, upon
completion of ineter installation.
The undersigned hereby applies to the City of Orono for issuance of a Utility Permit, agrees to do
all work in shict accordance with the ordinances of the City and the regulations of the State of
Minnesota, and certifies that all statements made on this application are,true and coirect.
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Applicant:��2�—` , ��� Date: �✓ � �
DATE TIME V
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
PERMIT NO. �/��lf�z COMPLETED �6•Z 7 •O L
ADDRESS �� �� �t�o+^o STbwv�► �ro,/l
OWNER �^r CONTR.
TELEPHONE NO.
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLiNG
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS: ��� ��'�'�'�� C� �f�
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W �tNORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
�/O CORRECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALI FOR REtNSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITNIN HOURS. � pH0T0 TAKEN
INSPECTOR WILL RETURN
❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �952� Z49-46QQ
Owner/Contractor n ' e•
Inspector.
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